Finite Element Analysis of Dynamic Changes in Spinal Mechanics of Osteoporotic Lumbar Fracture

Overview

Journal Eur J Med Res

Publisher Biomed Central

Specialty General Medicine

Date 2022 Aug 6

PMID 35933368

Authors

Jianwen Yan

Zhong Liao

Yafang Yu

Affiliations

Soon will be listed here.

Abstract

Aim: This study aims to explore the effects of finite element biomechanical properties of different methods in the treatment of osteoporotic thoracolumbar fractures.

Methods: Based on the ultra-thin computed tomography scan data of a volunteer's thoracolumbar spine, the finite element method was used to simulate the treatment of osteoporotic thoracolumbar fracture. Spiral computed tomography scanning was used to obtain images of the thoracolumbar region, which was then imported into Mimics software to obtain the three-dimensional geometric model. The finite element model of normal T - L segment was established by finite element software Abaqus and the validity of the model loading was verified. The finite element model of T vertebral compression fracture was established based on normal raw data. The clinical overextension reduction manipulation was simulated by different treatment methods and the changes in stress and displacement in different parts of injured vertebrae were analyzed.

Results: An effective finite element model of T-L segment was established. The maximum stress, axial compression strength, axial compression stiffness, and transverse shear stiffness were significantly better in the percutaneous kyphoplasty and percutaneous vertebroplasty treatment group than in the conservative treatment group and open treatment group (P < 0.05). Additionally, there was no significant difference between the open treatment group and conservative treatment group, or between the PKP and PVP treatment group.

Conclusion: Percutaneous vertebroplasty and percutaneous kyphoplasty not only met the requirements of normal functional kinematics of thoracolumbar spine, but also restored the stability of thoracolumbar spine. They had good biomechanical properties and remarkable application effects. The application of finite element analysis can help select a scientific, reasonable, and effective treatment scheme for the clinical diagnosis and treatment of osteoporotic thoracolumbar fractures.

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References

Park J, Kim J, Lee Y, Gwon J, Park Y . Intra-cardiac Embolism of a Large Bone Cement Material after Percutaneous Vertebroplasty Removed through a Combination of an Endovascular Procedure and an Inferior Vena Cava Exploration: a Case Report. J Korean Med Sci. 2018; 33(19):e141. PMC: 5934517. DOI: 10.3346/jkms.2018.33.e141. View

Lopez E, Ibarz E, Herrera A, Puertolas S, Gabarre S, Mas Y . A predictive mechanical model for evaluating vertebral fracture probability in lumbar spine under different osteoporotic drug therapies. Comput Methods Programs Biomed. 2016; 131:37-50. DOI: 10.1016/j.cmpb.2016.04.006. View

Szamatowicz M . How can gynaecologists cope with the silent killer - osteoporosis?. Prz Menopauzalny. 2017; 15(4):189-192. PMC: 5327627. DOI: 10.5114/pm.2016.65682. View

Kohno M, Iwamura Y, Inasaka R, Kaneko K, Tomioka M, Kawai T . Surgical Intervention for Osteoporotic Vertebral Burst Fractures in Middle-low Lumbar Spine with Special Reference to Postoperative Complications Affecting Surgical Outcomes. Neurol Med Chir (Tokyo). 2019; 59(3):98-105. PMC: 6434421. DOI: 10.2176/nmc.oa.2018-0232. View

Chang J, Bei M, Shu D, Sun C, Chen J, Xiao Y . Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell's disease:a prospective cohort study. BMC Musculoskelet Disord. 2020; 21(1):238. PMC: 7155268. DOI: 10.1186/s12891-020-03271-9. View

Weaver C, Gordon C, Janz K, Kalkwarf H, Lappe J, Lewis R . The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 2016; 27(4):1281-1386. PMC: 4791473. DOI: 10.1007/s00198-015-3440-3. View

Tseng C . Metformin use is associated with a lower risk of osteoporosis/vertebral fracture in Taiwanese patients with type 2 diabetes mellitus. Eur J Endocrinol. 2020; 184(2):299-310. DOI: 10.1530/EJE-20-0507. View

Li Z, Wang Y, Xu Y, Xu W, Zhu X, Chen C . Efficacy analysis of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with kyphosis. J Orthop Surg Res. 2020; 15(1):53. PMC: 7027033. DOI: 10.1186/s13018-020-1583-1. View

Kanis J . Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002; 359(9321):1929-36. DOI: 10.1016/S0140-6736(02)08761-5. View

10.

K U, R V . Finite element analysis of lower limb exoskeleton during sit-to-stand transition. Comput Methods Biomech Biomed Engin. 2021; 24(13):1419-1425. DOI: 10.1080/10255842.2021.1892658. View

11.

ONeill T, Cockerill W, Matthis C, Raspe H, Lunt M, Cooper C . Back pain, disability, and radiographic vertebral fracture in European women: a prospective study. Osteoporos Int. 2004; 15(9):760-5. DOI: 10.1007/s00198-004-1615-4. View

12.

Denis F . The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976). 1983; 8(8):817-31. DOI: 10.1097/00007632-198311000-00003. View

13.

Clark W, Bird P, Gonski P, Diamond T, Smerdely P, McNeil H . Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2016; 388(10052):1408-1416. DOI: 10.1016/S0140-6736(16)31341-1. View

14.

Couvertier M, Germaneau A, Saget M, Dupre J, Doumalin P, Bremand F . Biomechanical analysis of the thoracolumbar spine under physiological loadings: Experimental motion data corridors for validation of finite element models. Proc Inst Mech Eng H. 2017; 231(10):975-981. DOI: 10.1177/0954411917719740. View

15.

Yu D, Kim S, Jeon I . Therapeutic Effect of Teriparatide for Osteoporotic Thoracolumbar Burst Fracture in Elderly Female Patients. J Korean Neurosurg Soc. 2020; 63(6):794-805. PMC: 7671788. DOI: 10.3340/jkns.2020.0110. View

16.

Hirsch J, Chandra R, Pampati V, Barr J, Brook A, Manchikanti L . Analysis of vertebral augmentation practice patterns: a 2016 update. J Neurointerv Surg. 2016; 8(12):1299-1304. DOI: 10.1136/neurintsurg-2016-012767. View

17.

Deng X, Xiong X, Wan D, Shi H, Mei G, Cui W . Modified percutaneous Kyphoplasty technique in the treatment of osteoporotic thoracolumbar burst fractures: could it reduce the odds of cement leakage?. BMC Surg. 2020; 20(1):96. PMC: 7206719. DOI: 10.1186/s12893-020-00753-4. View

18.

Xu Z, Hao D, He L, Guo H, He B, Liu T . An assessment system for evaluating the severity of thoracolumbar osteoporotic fracture and its clinical application: A retrospective study of 381 cases. Clin Neurol Neurosurg. 2015; 139:70-5. DOI: 10.1016/j.clineuro.2015.09.006. View

19.

Roman M, Brown C, Richardson W, Isaacs R, Howes C, Cook C . The development of a clinical decision making algorithm for detection of osteoporotic vertebral compression fracture or wedge deformity. J Man Manip Ther. 2011; 18(1):44-9. PMC: 3103109. DOI: 10.1179/106698110X12595770849641. View

20.

Lee S, Oh H, Lee S, Lee H, Hwang B . Cement Augmented Anterior Reconstruction and Decompression without Posterior Instrumentation: A Less Invasive Surgical Option for Osteoporotic Thoracolumbar Fracture with Cord Compression. Korean J Neurotrauma. 2020; 16(2):190-199. PMC: 7607031. DOI: 10.13004/kjnt.2020.16.e37. View